Age, left atrial dimension and arterial stiffness after external cardioversion of atrial fibrillation. A vascular component in arrhythmia maintenance? Results from a preliminary study

Abstract

Background and AimsAtrial fibrillation (AF) is the most frequent arrhythmia in elderly patients. Aims of this study were to evaluate the predictors of arterial stiffness after external cardioversion (ECV) of AF and to establish whether a link exists between vascular properties and left atrial diameter (LAD).MethodsWe studied 33 patients (age 73 ± 12 years). After 5 h from ECV of persistent AF, an echocardiogram was recorded and arterial stiffness was evaluated with cardio-ankle vascular stiffness index (CAVI).ResultsIn multivariate analysis (R = 0.538, p = 0.006), CAVI (mean 9.60 ± 1.63) increased with age (p = 0.018) and with an AF length ≤3 months (p = 0.022). LAD was significantly related to CAVI (p = 0.007) even after adjustment for interventricular septum thickness (p = 0.018) (R = 0.574, p = 0.002).ConclusionsIn patients with AF, immediately after ECV, arterial stiffness is associated with age and AF length, and could represent an important factor for left atrium remodeling and, therefore, for AF maintenance.

Atrial fibrillation after electrical cardioversion in elderly patients: a role for arterial stiffness? Results from a preliminary study

“…A possible explanation could be represented by the association between CAVI and left atrium diameter, which is independent of left ventricular thickness [3]. Once again, low-grade inflammation could be the link between aortic stiffness and left atrium dilation [15].…”

“…The cardio-ankle vascular index (CAVI) [3, 7], a measure of AS, independent from instantaneous systolic and pulse pressure, was evaluated immediately before discharge using VaSera VS-1500N (Fukuda Denshi, Japan). During the continuous recording of EKG and heart sounds, right and left upper and lower extremity arterial pressure was obtained with the oscillometric method.…”

“…Arterial stiffness (AS) increases with age and predicts coronary heart disease, stroke and mortality [2]. In a previous pilot study on AF patients, we found that AS could represent an important factor associated with left atrium (LA) remodeling [3]. In the present study, we evaluated whether AS has a role in sinus rhythm maintenance in elderly subjects undergoing elective electrical cardioversion (ECV) of persistent AF.…”

Arterial stiffness and atrial fibrillation: a new and intriguing relationship

“…13 On this basis, we conducted two consecutive studies. 14,15 The first was aimed at determining the clinical factors correlated to AS in a population of patients who underwent external cardioversion (ECV) of the persistent forms of the arrhythmia. Then, we verified if an association exists between AS, left atrial and left ventricular dimensions.…”

“…The existence of this link could justify the incidence of relapses after sinus rhythm restoration. 14 With the second study, we aimed at evaluating in a new population of aged patients if AS can be related to sinus rhythm maintenance after ECV. 15 For this purpose, we took into consideration also interleukin-6 (IL-6) concentration, which revealed itself to be associated with both AS and AF relapses.…”